Kornimate/medical-research-clean huggingface dataset:
acute metabolic effects of estradiol

Conditions: Postmenopause

Summary: estradiol promotes and maintains the typical female phenotype characterized by subcutaneous fat accumulation. there is evidence to suggest that this effect relies on the ability of estradiol to increase the amount of anti-lipolytic α2a-adrenergic receptors, but whether this requires long-term exposure to estradiol or is the result of an immediate effect is not clear. objective: to study acute effects of a single dose (4 mg) of 17β-estradiol on regional and systemic lipolysis.

estradiol affects muscle and fat distribution, and thereby lipid metabolism. a reduction in muscle power is seen after menopause, readily counteracted by female hormone therapy (ht). treatment with ht through months to previously untreated postmenopausal women, or hormone replacement therapy (hrt) to women with turner syndrome, increases muscle mass and reduces fat mass. ht in postmenopausal women furthermore prevents fat accumulation and increases lipoprotein lipase activity and lipolysis to an extent comparable to premenopausal women. in contrast, it has also been shown that estradiol may actually attenuate lipolysis during basal as well as catecholamine stimulated conditions. in addition, one study found whole body fat metabolism to be lower during treatment with estradiol than without, and reduced lipolysis is present in postmenopausal women during treatment with estradiol, along with an increased number of α-adrenergic receptors and a decreased number of β-adrenergic receptors. it is not clear whether the lipolytic effect of estradiol happens acutely or is dependent on chronic exposure. moreover, regional differences in the pharmacodynamics of estradiol have not been assessed. finally, effects on skeletal muscle have never been examined. the purpose of the present study was 1) by microdialysis to quantify the regional production of glycerol in two tissues (muscle and fat), and in two regions (abdominal and femoral). 2) to quantify the whole-body lipolytic effect of estradiol, and 3) in biopsies to study intracellular mechanisms behind the action of estradiol.

Eligibility criteria:
inclusion criteria: * postmenopausal women assessed by fsh and estradiol levels * not taking any drugs * non-smokers exclusion criteria: * obesity (bmi\>30)

Keywords: estradiol lipolysis estrogen receptor adrenergic receptors ucp2 postmenopausal women
response rate and duration after discontinuation thrombopoietin receptor agonists primary immune thrombocytopenia

Conditions: Immune Thrombocytopenia

Summary: the primary objective of the study is the evaluation of sustained response rate after discontinuation of treatment with tpo-ras, eltrombopag and romiplostim, in persistent or chronic pitp patients who failed one or more therapy lines, splenectomy included.

increasing evidence exists in the literature on the persistent response after tpo-ras discontinuation. however, the available data consist of description of case reports from different patients' series. at this time, systematic data collections on this topic do not exist and the real incidence of such persistent response is unknown. therefore, because of the increasing interest in this new and challenging therapeutic field, also for the therapeutic implications, we would like to investigate the impact of tpo- ras on the achievement of sustained and persistent responses after their discontinuation in the italian adult patients affected by pitp who have been referred to the gimema centers.

Eligibility criteria:
inclusion criteria: * signed written informed consent according to ich/eu/gcp and national local laws; * persistent or chronic pitp adult patients who have been treated with tpo-ras therapy after failure of one or more therapy lines, splenectomy included; * age \> 18 years. exclusion criteria: * active malignancy; * active malignancy; * hcvab, hivab, hbsag, hbcab seropositive status; * chronic liver disease; * treatment with rituximab less than 8 weeks before tpo-ras start; * recent splenectomy (less than 8 weeks) before tpo-ras start. active malignancy; * hcvab, hivab, hbsag, hbcab seropositive status; * chronic liver disease; * treatment with rituximab less than 8 weeks before tpo-ras start; * recent splenectomy (less than 8 weeks) before tpo-ras start. hcvab, hivab, hbsag, hbcab seropositive status; * chronic liver disease; * treatment with rituximab less than 8 weeks before tpo-ras start; * recent splenectomy (less than 8 weeks) before tpo-ras start.

Keywords: immune thrombocytopenia primary thrombopoietin receptor agonist
video assisted thoracoscopic lobectomy versus conventional open lobectomy for lung cancer

Conditions: Lung Neoplasms

Summary: lung cancer is the leading cause of cancer death worldwide and survival in the united kingdom (uk) remains amongst the lowest in europe. surgery is the main method of managing early stage disease and is traditionally undertaken via conventional open surgery. however, over the last decade there has been a surge in the number of minimal access resections performed using video-assisted thoracoscopic surgery (vats). however, there remains a need for well-designed and conducted randomised controlled trial (rct) to provide the evidence base for the wide spread uptake and delivery of this surgical approach.

the uptake of surgery for lung cancer in the uk is low and minimal access surgery may be regarded as a more acceptable intervention (compared to open surgery) by patients, referring respiratory physicians and oncologists. however, a large multi-centre rct is essential to inform patient and clinician decision making and influence surgical practice in the uk. the violet study will compare the effectiveness, cost-effectiveness and acceptability of vats lobectomy versus open surgery for treatment of lung cancer and will test the hypothesis that vats surgery is superior to open surgery with respect to self-reported physical function five weeks after randomisation (approx. one month after surgery). specific objectives are to estimate: a. the difference between groups in the average self-reported physical function at five weeks. b. the difference between groups with respect to a range of secondary outcomes including assessment of efficacy (hospital stay, pain, proportion and time to uptake of chemotherapy), measures of safety (adverse health events), oncological outcomes (proportion of patients upstaged to pn2 disease and disease free survival) and overall survival. c. the cost effectiveness of vats and open surgery.

Eligibility criteria:
inclusion criteria: 1. adults aged ≥16 years of age 2. able to give written consent, undergoing either: i. lobectomy or bilobectomy for treatment of known or suspected primary lung cancer beyond lobar orifice\* in tnm8 stage ct1-3 (by size criteria, equivalent to tnm7 stage ct1a-2b) or ct3 (by virtue of 2 nodules in the same lobe), n0-1 and m0 or ii. undergoing frozen section biopsy with the intention to proceed with lobectomy or bilobectomy if primary lung cancer with a peripheral tumour beyond a lobar orifice\* in tnm8 stage ct1-3 (by size criteria, equivalent to tnm7 stage ct1a-2b) or ct3 (by virtue of 2 nodules in the same lobe), n0-1 and m0 is confirmed 3. disease suitable for both minimal access (vats) and open surgery exclusion criteria: 1. adults lacking capacity to consent 2. previous malignancy that influences life expectancy 3. patients in whom a pneumonectomy, segmentectomy or non-anatomic resection (e.g. wedge resection) is planned 4. patients with a serious concomitant disorder that would compromise patient safety during surgery. 5. planned robotic surgery

Keywords: lung cancer lobectomy
effects of treatment with high flow nasal cannulas on respiratory pattern and work of breathing among healthy subjects

Conditions: Respiratory Failure

Summary: this study evaluates the work of breathing among healthy subjects under various conditions of treatment with high flow nasal cannulas. ten subjects will be included. the design of this study is a cross over of five treatment periods with different flow settings.

high flow oxygen therapy (hfot) is a promising technique increasingly used in the management of acute respiratory failure. in hospitalised hypoxemic patients, recent clinical evidence showed that hfot can reduce endotracheal intubation and reduce mortality. physiologically, the hfot causes a decrease in respiratory rate and minute-ventilation and may be associated with a decrease in carbone dioxyde arterial pressure. it is possible that these effects are associated with decreased work of breathing, which could explain some of the benefits in terms of comfort and efficiency. the objective of this research is to evaluate the impact of a wash-out of anatomical dead space by high flow nasal cannulas on respiratory parameters and on the work of breathing among healthy subjects. the investigators will evaluate the baseline status in room air, and then compare it with four different levels of flow. the primary endpoint will be the work of breathing.

Eligibility criteria:
inclusion criteria: * healthy subjects * written and informed consent exclusion criteria: * pregnant or breastfeeding women; * subject enrolled in another study excluding co-enrolment; * cardio-vascular or respiratory disease; * history of ear nose and throat disease (i.e. surgery, epistaxis, trauma), eso-gastric disease (i.e. esophageal varices, digestive haemorrhage), rheumatologic or neurologic disease possibly interfering with the design of the study; * subject feeling nauseous or under recent fed condition (\<1h).
tsh and amh in infertile women

Conditions: Infertility

Summary: infertility is defined as the inability of a couple to achieve pregnancy over an average period of one year (in women under 35 years of age) or 6 months (in women above 35 years of age) of unprotected sexual intercourse. infertility can be due to female, male reasons or both. it can be either primary or secondary. thyroid dysfunction and autoimmune thyroiditis are known adverse risk factors for pregnancy as well as fertility, regardless of the presence of disease in women of reproductive age. in particular, hypothyroid women are at an increased risk of menstrual disorders and infertility because of altered peripheral estrogen metabolism, hyperprolactinaemia and abnormal release of gonadotropin-releasing hormone. the prevalence of subclinical hypothyroidism characterized by aberrant high serum thyroid-stimulating hormone (tsh) levels with normal free thyroxin (ft4) levels in infertile women are reported to be approximately 20% and it is a primary cause of subfertility. indeed, average tsh levels in infertile women were reportedly higher than those in normal fertile women. and elevated serum tsh levels were associated with diminished ovarian reserve in infertile patients. moreover, although levothyroxine replacement therapy for subclinical hypothyroidism in infertile patients remains debatable, thyroxin supplementation may improve fertility to successful pregnancy. this data suggests that hypothyroidism is strongly correlated with infertility (velkeniers et al., 2013). on the other hand, female fecundity decreases with increasing age, primarily because of decreased ovarian function. anti-mullerian hormone (amh) is a dimeric glycoprotein belonging to the transforming growth factor-beta (tgf-b) super family, which act on tissue growth and differentiation. it is produced by the granulosa cells from pre-antral and small antral follicles. ovarian research after oophorectomy showed that serum amh levels were closely correlated with the number of primordial follicles; therefore, amh is a suitable biomarker of ovarian age in women of reproductive age. expectedly, ovarian function may be affected by impaired thyroid function, although this association has not been elucidated. in this study, we will evaluate the relationship between thyroid function and amh levels by comparing them in infertile patients and healthy fertile women.


Eligibility criteria:
inclusion criteria: 1. age: 20-35 years 2. diagnosed as primary infertility. 3. duration of marriage more than 1 year. 4. controls should be normal fertile women aged 20- 35 years had no history of treatment for infertility or thyroid disorders. exclusion criteria: 1. age: above 35 years old. 2. women with ovarian dysfunction (pco, post ovarian surgery). 3. treated thyroid dysfunction (autoimmune thyroiditis, hypothyroidism).
botulinum toxin type a (botox®) treatment of masseter muscle hypertrophy

Conditions: Masseter Muscle Hypertrophy

Summary: this study will evaluate the safety and efficacy of a range of doses of botulinum toxin type a (botox®) for the treatment of patients with bilateral masseter muscle hypertrophy (mmh).


Eligibility criteria:
inclusion criteria: -participants with masseter muscle hypertrophy exclusion criteria: * diagnosis of myasthenia gravis, eaton-lambert syndrome, amyotrophic lateral sclerosis, or any other condition that might interfere with neuromuscular function * prior botulinum toxin treatment of any serotype to the masseter muscle or lower face * history of dental or surgical procedure for lower facial shaping or masseter muscle reduction * history of or current temporomandibular joint disorder (tmjd)
evaluation of the analgesic efficacy of an ultrasound-guided transperineal pudendal block in outpatient hemorrhoidal surgery

Conditions: Hemorrhoids

Summary: in a population of patients undergoing hemorrhoidal surgery under general anesthesia and divided into two equal groups based on the method used for intraoperative pudendal nerve block and its branches in the ischioanal fossa: group 1: pudendal block guided by neurostimulation group 2: pudendal block guided by ultrasound the primary objective of this study is to compare the maximum immediate postoperative pain score between the two groups (pain reported by the patients in the recovery room on a simple numeric scale before morphine titration).

this is a multicenter, prospective, randomized, double-blind study conducted on two parallel groups of patients undergoing hemorrhoidal surgery (pudendal block guided by neurostimulation versus pudendal block guided by ultrasound). study duration the total study duration per patient is 7 days. the recruitment period is set at 12 months. justification of the experimental protocol the aim of this study is to compare two methods of performing a pudendal block. patient allocation to either strategy will be determined by randomization. bilateral pudendal nerve block and its branches in the ischioanal fossa will be performed after induction of general anesthesia. to maintain double blinding, postoperative data will be collected by a physician other than the anesthesiologist performing the block, and by nursing staff under their supervision. none of these personnel will be informed of the patient's group allocation.

Eligibility criteria:
inclusion criteria: * adult male or female patient * patient who has signed informed consent to participate in the study * patient scheduled for outpatient hemorrhoidal surgery under general anesthesia exclusion criteria: * history of hemorrhoidal surgery * allergy or contraindication to any of the medications used in the study * patient undergoing surgery under spinal anesthesia * history of chronic pain requiring opioid use, unrelated to hemorrhoids * mental impairment or any other condition that could hinder understanding or strict adherence to the protocol * patient not affiliated with the french national health insurance system * patient under legal protection (e.g., guardianship, trusteeship, or court protection) * pregnant woman or woman at risk of being pregnant (i.e., of childbearing age without effective contraception and without an hcg test) * patient already enrolled in another therapeutic clinical trial or within the exclusion period of another clinical trial

Keywords: hemorroidal surgery
brief mindfulness intervention for pain before an in-clinic orthopedic procedure

Conditions: Pain; Chronic Pain; Acute Pain

Summary: this project is a single-site, randomized controlled trial designed to investigate the impact of a 7-minute mindfulness intervention on pain among patients undergoing kyphoplasty or radiofrequency ablation.


Eligibility criteria:
inclusion criteria: * undergoing kyphoplasty or radiofrequency ablation at tallahassee orthopedic center * fluency with english * being 18 and above exclusion criteria: * unable to consent because of physical or mental incapacity.

Keywords: mindfulness kyphoplasty radiofrequency ablation
characterization of brain metastases

Conditions: Neoplasm Metastasis; Lung Neoplasms; Breast Neoplasms; Melanoma

Summary: the purpose is to characterize tumour biological markers in brain metastases tissue from patients with different primary tumour by using ex vivo techniques as high-resolution magic angle spinning mr spectroscopy and micro array.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of brain metastases exclusion criteria: * children * pregnancy

Keywords: brain metastasis hr mas spectroscopy tissue micro array dna micro array
tee guided adjusting cpr location

Conditions: Cardiac Arrest (CA)

Summary: use transesophageal ultrasound in ohca patients to identify the proper compression location

for patients with cardiac arrest, high-quality cardiopulmonary resuscitation is performed according to critical care management and advanced cardiac life support (acls). rapid with powerful chest compression should be performed to maintain the heart's output and blood flow. an advanced airway should be established and adjust resuscitation based on collected clinical information. transesophageal ultrasound examination is performed after the advanced airway is established without affecting the resuscitation. the investigators use the built-in ultrasound software (philips qlab 3d quantification advance, philips healthcare, usa, speckle tracking echocardiography (ste,speckle tracking echocardiography)) to analyze stroke volume and cardiac output. the investigators collect the stroke volume and cardiac output at the chest compression position recommended by acls, as well as the stroke volume and cardiac output after adjusting the optimal chest compression position. the investigators expect it can increase the return of spontaneous circulation rate, survival rate, and neurological prognosis over time.

Eligibility criteria:
inclusion criteria: * out of hospital cardiac arrest patients exclusion criteria: * dnr was signed * age under 18 * trauma patients * patients hard to establish advanced airway

Keywords: ohca tee
knee arthroscopy for pain control

Conditions: Knee Arthroscopy

Summary: this study aims to determine the effectiveness of an anterolateral genicular nerve block and portal anesthesia in controlling pain in the perioperative period after knee arthroscopy. opioid consumption, the use of non-opioid medications, complication rate, and sleep quality will also be measured.

orthopaedic surgeries are some of the most painful operations to recover from, especially when involving cruciate ligaments. because of this, orthopaedic surgeons have worked to optimize postoperative pain management that provides the best relief. opioids traditionally were the primary medication for pain control during the perioperative period, however, with the current opioid epidemic and opioids being the leading cause of accidental deaths in the united states, physicians have transitioned to multimodal pain control which has shown to provide better pain control. in cases involving knee arthroscopy, pain management options include variations of nerve blocks, medications, surgical techniques, and postoperative activity. an anterolateral genicular nerve block has been proposed that focuses on decreasing postoperative pain in the lateral aspect of the knee by targeting the lateral retinacular nerve, the nerve to the vastus lateralis, and the articular branch of the nerve to the vastus intermedius. adductor canal blocks and intraarticular injections are known methods of providing postoperative pain control, but due to their risks, they may be inappropriate for knee arthroscopy. an anterolateral geniculate nerve block targets sensory, terminal nerve fibers outside the joint capsule, theoretically avoiding the risks of large nerve irritation and chondrotoxicity. postoperative portal injections are another form of analgesia provided after knee arthroscopy and have been demonstrated to be equally effective in controlling pain as intraarticular injections one hour postoperatively. otherwise, portal injections in knee arthroscopy have not been extensively studied in the literature. patients will be sent home after surgery with a survey to be completed at 2, 4, 6, 12, 24, and 48 hours and 1 week. the survey will inquire about the period from the prior survey to the current survey and will evaluate pain via visual analog score, opioid consumption, non-opioid medication use, sleep, and intervention complications. patients will be called at 12 and 48 hours and 1 week as reminders to complete the survey.

Eligibility criteria:
inclusion criteria: * skeletally mature patients with indications for knee arthroscopy exclusion criteria: * include patients with previous knee surgery on the operative side * opioid use within six weeks before surgery that is deemed to be chronic or excessive * gabapentin use within six weeks before surgery * diagnosis of chronic pain, fibromyalgia, or other somatosensory disorder(s) * history of radicular pain or neuropathy in the operative limb * patients with cancer
the effect of home-based rehabilitation program after covid-19 infection

Conditions: COVID-19

Summary: to follow up the cardiopulmonary function after coronavirus disease 2019 (covid-19) infection and compare the effect of a 12-week home-based cardiopulmonary with or without add-on remote rehabilitation on the cardiopulmonary function, emotion and quality of outcome.

the investigators will recruit the patients post-covid infection for a cardiopulmonary function evaluation and a home-based rehabilitation program. the investigators hypothesize that an add-on remote rehabilitation on a home-based rehabilitation has a better effect than a home-based rehabilitation alone on the compliance rate for the exercise, and also a better outcome in terms of cardiopulmonary function testing, 6-minute walking test, physical activities and quality of life, as well as less dyspnea, depression and anxiety.

Eligibility criteria:
inclusion criteria: 1. ≥ 20 years of age. 2. covid-19 survivor after de-isolation at post-acute stage about to be discharged or already at outpatient follow-up who still have symptoms or exercise intolerance. exclusion criteria: 1. unable to cooperate with rehabilitation or evaluation. 2. dependent in basic activities of living before infection (premorbid barthel index \<80). 3. end stage patient, with life expectancy less than 1 year. 4. having contraindications for exercise according to the evaluation of a physician.

Keywords: covid-19 rehabilitation cardiopulmonary exercise testing
zanubrutinib for hlh

Conditions: HLH

Summary: this study is a prospective single-arm clinical study, focusing on hemophagocytic lymphohistocytosis，to evaluate the clinical efficacy and safety of zanubrutinib.


Eligibility criteria:
inclusion criteria: 1. unlimited gender, age ≥ 14 years old; 2. hlh was diagnosed according to hlh-04 diagnostic criteria; 3. before the study, there was no severe liver function injury; serum creatinine ≤ 1.5 times the upper limit of normal value; 4. sign informed consent exclusion criteria: 1. allergic to zebutinib; 2. currently active important cardiovascular diseases with clinical significance; the functions of important organs such as heart and lung unrelated to hlh were seriously abnormal; 3. known human immunodeficiency virus (hiv) or active hepatitis b (hbv) or hepatitis c (hcv) infection; 4. pregnant or lactating women and patients of childbearing age who refuse to take appropriate contraceptive measures during this trial; 5. serious mental illness; 6. active massive hemorrhage of internal organs; 7. uncontrollable infection; 8. at the same time, participate in other clinical researchers